CVS Caremark's Brennan outlines employer healthcare options for 2014 to National Business Group on Health

By Antoinette Alexander

BOSTON — If employers want to best manage the health and productivity of their employees, they need to continue company-sponsored health plans — that was a key message that Troyen Brennan, EVP and chief medical officer of CVS Caremark, had for attendees at the National Business Group on Health's annual meeting on Thursday.

The message comes in light of the fact that employers face a fundamental decision concerning employee healthcare benefits when health reform-required insurance exchanges take center stage in 2014: Should their companies continue employer-sponsored insurance plans or should they move employees to programs offered through public exchanges?

"The decision you make regarding how to manage your employees' health care moving forward is important for your employees and your business," Brennan said. "Do you stay in the driver's seat and proactively manage the health and productivity of your workforce, or do you climb into the back seat and take your chances?"

Brennan, a former professor of medicine, law and public health at Harvard University and who formerly served as president and CEO of Brigham and Women's Physician Organization and chief medical officer of Aetna before joining CVS Caremark, brings extensive health system experience to the NBGH address.

He reviewed projections from six different analysts on the impact the recently passed Affordable Care Act will have on the healthcare market. That review included forecasts from the Congressional Budget Office, Rand Corp., Urban Institute, Goldman Sachs, the Lewin Group, Deutsche Bank and one developed for CVS Caremark. While all the independent projections forecasted the nation's uninsured population will signficantly drop as a result of the healthcare-reform law, they were not conclusive as to the future of employee-sponsored health plans. Several projections forecasted market shrinkage of employee-sponsored health coverage, while others show slight growth.

The heart of the presentation was Brennan's review of research looking at the successes and shortcomings of health-and-wellness programs in the workplace, and the impact those programs have on medical costs. Brennan said 25 years of peer-reviewed studies show inconsistent results. For example, recent research into healthcare savings resulting from aggressive smoking cessation and weight-loss programs showed employers realizing significant medical cost savings. One study looking at smoking cessation programs projected 10-year savings in excess of $7 billion. However, Brennan said other studies found less dramatic, sometimes mixed results when it comes to medical cost savings.

"I wish the literature was conclusive, but it is not," Brennan said. "What we know is that there are actions and programs that have had a direct impact on employee heath and productivity. It seems clear those of us in the healthcare industry have to be creative and diligent in developing and administering these programs, because absenteeism and productivity go to the bottom line," Brennan said.

"We found successful programs are run by companies where the leadership fully supports developing a healthy culture. The research shows employers need to use all the tools at their disposal — Web, telephone, incentives and face-to-face counseling — to encourage healthy individual behaviors. By aggressively managing employee benefits, we can achieve a healthy and productive workforce and lower medical costs," Brennan concluded.